Vol. 552 No. 3
114 Mr. R. Bruton asked the Minister for Health and Children his policy in relation to the recognition of therapies for eating disorders; his plans to extend cover for such therapies under the medical card; and the terms of voluntary health insurance schemes which receive State recognition by way of tax relief. [12287/02]
Responsibility for the management and treatment of a person with an eating disorder rests with the individual patient's clinician. Eligibility for a medical card is solely a matter for the chief executive officer of the relevant health board to decide. In determining eligibility, the chief executive officer has regard to the applicant's financial circumstances. Health boards use income guidelines to assist in determining eligibility. However, where a person's income exceeds the guidelines, a medical card may be awarded if the chief executive officer considers that the person's medical needs or other circumstances would justify this. Medical cards may also be issued to individual family members on this basis.
Under the regulatory framework for private health insurance, insurers are obliged to provide prescribed minimum levels of benefit specified in the Health Insurance Act, 1994 (Minimum Benefit) Regulations, 1996. These minimum requirements were determined in the context of opening the market to competition under the EU Non-Life Insurance Directive 92/49/EEC – Third Directive – and by reference to the established minimum level of cover generally available to insured persons at the time. Health services relating to eating disorders or weight reduction are not prescribed.
The prescribed health services include in-patient services, day patient services, out-patient services, the sole purpose of which is the medical investigation, treatment, cure, or alleviation of the symptoms, of illness or injury. My Department is aware that cover is made available in respect of treatment for anorexia nervosa and bulimia nervosa on an in-patient basis. It is a matter for all insurers to determine what benefits they are in a position to provide over and above those required under minimum benefit arrangements.
